Risk for suicidal behaviors associated with PTSD, depression, and their comorbidity in the U.S. Army

Authors

Holly J. Ramsawh, Uniformed Services University of the Health SciencesFollow
Carol S. Fullerton, Uniformed Services University of the Health Sciences
Holly B. Herberman Mash, Uniformed Services University of the Health Sciences
Tsz Hin H. Ng, Uniformed Services University of the Health Sciences
Ronald C. Kessler, Harvard Medical SchoolFollow
Murray B. Stein, University of California, San DiegoFollow
Robert J. Ursano, Uniformed Services University of the Health Sciences

Date of this Version

2014

Citation

Journal of Affective Disorders 161 (2014) 116-122

Comments

This article is a U.S. government work, and is not subject to copyright in the United States.

Abstract

Background: Suicide rates have risen considerably in the United States Army in the past decade. Suicide risk is highest among those with past suicidality (suicidal ideation or attempts). The incidence of posttraumatic stress disorder (PTSD) and depressive illnesses has risen concurrently in the u.s. Army. We examined the relationship of PTSD and depression, independently and in combination, and rates of pastyear suicidality in a representative sample of U.S. Army soldiers. Methods: This study used the 000 Survey of Health Related Behaviors Among Active Duty Military Personnel (000 HRB) (N=5927). Probable PTSD and depression were assessed with the PTSD Checklist (PCL) and the 10-item short form of the Center for Epidemiologic Studies Depression Scale (CES-D), respectively. Past-year suicidality was assessed via self-report. Results: Six percent of Army service members reported suicidality within the past year. PTSD and MOD were each independently associated with past-year suicidality. Soldiers with both disorders were almost three times more likely to report suicidality within the past year than those with either diagnosis alone. Population-attributable risk proportions for PTSD, depression, and both disorders together were 24%, 29%, and 45%, respectively. Limitations: The current study is subject to the limitations of a cross-sectional survey design and the selfreport nature of the instruments used. Conclusions: PTSD and depression are each associated with suicidality independently and in combination in the active duty component of the U.S. Army. Soldiers presenting with either but especially both disorders may require additional outreach and screening to decrease suicidal ideation and attempts.